Anastomotic leakage after curative anterior resection for rectal cancer: short and long‐term outcome
- 18 June 2010
- journal article
- research article
- Published by Wiley in Colorectal Disease
- Vol. 12 (7Online), e76-e81
- https://doi.org/10.1111/j.1463-1318.2009.01935.x
Abstract
The influence of symptomatic anastomotic leakage (AL) after anterior resection (AR) for rectal cancer on short and long-term mortality and local and distant recurrence was analysed. All patients with a first diagnosis of rectal carcinoma were prospectively registered in a national database. This comprised 1494 Danish citizens who had had a curative AR between May 2001 and December 2004. Data on survival and recurrence were obtained from the National Patient Register. Multivariate analyses were performed. Anastomotic leakage increased the 30-day mortality [odds ratio (OR) 4.01 (95% CI 2.24-7.17)]. Of other possible risk factors, only age had a significant interaction with leakage, as the risk of death within 30 days of AR decreased with increasing age. Long-term survival decreased significantly after AL [hazard ratio (HR) of 1.63, CI 1.21-2.19]. A total of 97 (6.7%) and 258 (18.0%) patients had local and distant recurrence respectively in the follow-up period. The risk of local and distant recurrence after AL was not different with HR of 1.50 (CI 0.84-2.69) and 1.13 (CI 0.76-1.69) respectively. No other factors influenced the risk of recurrence due to AL. Anastomotic leakage after AR for rectal cancer increases the 30-day and long-term mortality, but AL did not increase the risk of local and distant recurrence.Keywords
This publication has 16 references indexed in Scilit:
- Risk Factors and Oncologic Impact of Anastomotic Leakage after Rectal Cancer SurgeryDiseases of the Colon & Rectum, 2008
- Population-based study of risk factors for postoperative death after anterior resection of the rectumBritish Journal of Surgery, 2006
- Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancerBritish Journal of Surgery, 2005
- Prognosis After Anastomotic Leakage in Colorectal SurgeryDiseases of the Colon & Rectum, 2005
- Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patientsColorectal Disease, 2004
- Anastomotic Leakage Is Predictive of Diminished Survival After Potentially Curative Resection for Colorectal CancerAnnals of Surgery, 2004
- Anterior Resection for Rectal Cancer With Mesorectal ExcisionAnnals of Surgery, 2004
- Anastomotic leakage after curative anterior resection results in a higher prevalence of local recurrenceBritish Journal of Surgery, 2003
- Value of a Protective Stoma in Low Anterior Resections for Rectal CancerDiseases of the Colon & Rectum, 2002
- Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectumBritish Journal of Surgery, 1994